Medical Scheme Consultant

**Job Title:** Medical Scheme Consultant**Job Summary:** Paqueta Personnel is seeking a highly skilled Medical Scheme Consultant to join our team. As a Medical Scheme Consultant, you will be responsible for interacting with clients in a professional manner, handling new applications and amendments, and providing expert advice on medical schemes.**Key...

My client, a leading and wellknown Medical Scheme Consultancy requires a competent and experienced Medical Scheme Consultant to be placed onsite on the campus of a reputable university in Pretoria.Requirements:Matric / Grade 12 Certificate ESSENTIALRE5 Qualification PreferredNQF 5 Qualification (relevant to Medical Scheme Industry) PreferredAt least 3...

reputable Medical Aid is seeking a Junior PMB Consultant to join their team in Pretoria. **Duties**: - Administration of PMB and CDL treatment plan authorisations - Managing PMB referrals and supervising escalation inbox - Daily stats reporting - Supporting the Manager/Team Leader and other Managers in tasks and initiatives beneficial to the teams and to...

**Job Summary**HR Options is seeking a highly skilled and experienced Medical Schemes Administrator to join our team. As a key member of our administrative staff, you will be responsible for providing exceptional client service and administrative support to our clients.**Key Responsibilities:****Client Interaction & Administration:**Regular interaction with...

A reputable Medical Aid Scheme, based in Pretoria, is seeking a Pre-Authorisation Consultant to join their Hospital Benefit Management team. **Duties**: - Delivering cost-effective managed healthcare services to accomplish member satisfaction. - Assisting the Client by approving appropriate funding. - Delivering an effective Call Centre service in order to...

Our client, a managed care organisation based in Pretoria is looking for a Call Centre Agent. This is an equal opportunity organisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries. Position: Medical Call Centre Agent - Adding or removing of dependants - Processing medical scheme membership...

KPAs ü Assist the Chief Healthcare Officer in executing all clinical and medical advisory services within the Healthcare Management division and maintain clinical oversight on all aspects of the Schemes business. ü Ensure that the execution of clinical and medical advisory services within the Organisation are sound and in compliance with the Medical...

KPAsü Assist the Chief Healthcare Officer in executing all clinical and medical advisory services within the HealthcareManagement division and maintain clinical oversight on all aspects of the Schemes business.ü Ensure that the execution of clinical and medical advisory services within the Organisation are sound and incompliance with the Medical Schemes...

Our client, a managed care organisation in Pretoria are currently looking for a **Senior Manager: Operations. **Thisis an equal opportunity oganisation with various businesses and/ or subsidiaries that service clients in the medical scheme and insurance industries. **Reporting to**: Dual reporting role to both Chief Executive Officer and General...

A reputable Medical Aid is seeking an experienced Consultant to join their Service Providers, Contracting and Research Department. **Job Purpose**: To provide optimal support to the Healthcare Providers on the network, expand the network and to promote the Scheme. **Duties**: - Proactive Management for short paid claims and Overcharged Claims. - Increase...

Manager: External Stakeholder Support (Medical Doctor) Medical Scheme Pretoria KPAsü Manage the administrative function in the Medical Advisory Services business unitü Contribute to and conduct targeted research into local and international clinical guidelines andfunding policies.ü Critical review and analysis of current cost drivers and trends and...

Manager: External Stakeholder Support (Medical Doctor) Medical Scheme Pretoria KPAs ü Manage the administrative function in the Medical Advisory Services business unit ü Contribute to and conduct targeted research into local and international clinical guidelines and funding policies. ü Critical review and analysis of current cost drivers and...

Manager: External Stakeholder Support (Medical Doctor) Medical Scheme Pretoria KPAsü Manage the administrative function in the Medical Advisory Services business unitü Contribute to and conduct targeted research into local and international clinical guidelines andfunding policies.ü Critical review and analysis of current cost drivers and trends and...

Key Performance Areas (KPAs): ü Manage the administrative function in the Medical Advisory Services business unit ü Contribute to and conduct targeted research into local and international clinical guidelines and funding policies. ü Critical review and analysis of current cost drivers, and trends and compare with those of local and international...

Key Performance Areas (KPAs): ü Manage the administrative function in the Medical Advisory Services business unitü Contribute to and conduct targeted research into local and international clinical guidelines and fundingpolicies.ü Critical review and analysis of current cost drivers, and trends and compare with those of local andinternational sources for...

Medical Billing Bureau in Lynnwood Manor (Pretoria East) is excited to offer an employment opportunity to an experienced Medical Billing Administrator. Minimum requirements to apply: - Driver's license (ESSENTIAL). - Matric/Grade 12 qualification (ESSENTIAL). - 2 years Physiotherapy or Occupational Therapy billing experience (ESSENTIAL). - Computer skills...

Key Performance Areas (KPAs): ü Manage the administrative function in the Medical Advisory Services business unitü Contribute to and conduct targeted research into local and international clinical guidelines and fundingpolicies.ü Critical review and analysis of current cost drivers, and trends and compare with those of local andinternational sources...

A reputable Medical Aid is seeking a Pre-Auth Consultant to join their Call Centre team in Pretoria. A reputable Medical Aid Scheme, based in Pretoria, is seeking a Pre-Authorisation Consultant to join their Hospital Benefit Management team. **Duties**: - Delivering cost-effective managed healthcare services to accomplish member satisfaction. - Assisting...

The purpose of this position is to ensure that all claims are assessed using the appropriate rules and is paid correctly in line with the Scheme's benefit and tariff structures. **Duties**: - Assessing and processing Medical Aid claims - **Quality**:Measuring of individual error rate to ensure no costs incurred due to assessing errors made. -...

A reputable Medical Aid Scheme is seeking an experienced Risk Analyst to join their team in Pretoria. A reputable Medical Aid Scheme based in Pretoria is in search of an experienced Risk Analyst to join their team. **Job Purpose**: - The position is responsible for promoting risk and regulatory compliance by identifying, quantifying, reviewing,...